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Spreading Polio

July 13, 2011 permalink

While preaching best interest of the child to justify family destruction, the US has set real child protection back in its war on terror. The US is boasting about a phony vaccination campaign launched in Abbottabad Pakistan in an effort to get doctors inside the suspected residence of Osama bin Laden. There the vaccination needles were supposed to gather blood samples so that DNA tests could identify the children as bin Laden's.

To understand why this is such a setback, watch the TED talk by Bruce Aylward How we'll stop polio for good (local copy mp4). Polio has been nearly eradicated by vaccinating children in the world's poorest countries. One of the obstacles to vaccination is suspicion, sometimes spread by local religious leaders, that vaccination is part of a sinister plot to harm children. Those suspicions just got a big boost from the American war on terror.

Enclosed are two articles, one about the phony vaccination scam, the other discussing the setback to be expected in polio eradication.



CIA organised fake vaccination drive to get Osama bin Laden's family DNA

Senior Pakistani doctor who organised vaccine programme in Abbottabad arrested by ISI for working with US agents

bin Laden home
Osama bin Laden's compound in Abbottabad
CIA organised fake vaccination programme in Abbottabad to try and find Osama bin Laden.
Photograph: Md Nadeem/EPA

The CIA organised a fake vaccination programme in the town where it believed Osama bin Laden was hiding in an elaborate attempt to obtain DNA from the fugitive al-Qaida leader's family, a Guardian investigation has found.

As part of extensive preparations for the raid that killed Bin Laden in May, CIA agents recruited a senior Pakistani doctor to organise the vaccine drive in Abbottabad, even starting the "project" in a poorer part of town to make it look more authentic, according to Pakistani and US officials and local residents.

The doctor, Shakil Afridi, has since been arrested by the Inter-Services Intelligence agency (ISI) for co-operating with American intelligence agents.

Relations between Washington and Islamabad, already severely strained by the Bin Laden operation, have deteriorated considerably since then. The doctor's arrest has exacerbated these tensions. The US is understood to be concerned for the doctor's safety, and is thought to have intervened on his behalf.

The vaccination plan was conceived after American intelligence officers tracked an al-Qaida courier, known as Abu Ahmad al-Kuwaiti, to what turned out to be Bin Laden's Abbottabad compound last summer. The agency monitored the compound by satellite and surveillance from a local CIA safe house in Abbottabad, but wanted confirmation that Bin Laden was there before mounting a risky operation inside another country.

DNA from any of the Bin Laden children in the compound could be compared with a sample from his sister, who died in Boston in 2010, to provide evidence that the family was present.

So agents approached Afridi, the health official in charge of Khyber, part of the tribal area that runs along the Afghan border.

The doctor went to Abbottabad in March, saying he had procured funds to give free vaccinations for hepatitis B. Bypassing the management of the Abbottabad health services, he paid generous sums to low-ranking local government health workers, who took part in the operation without knowing about the connection to Bin Laden. Health visitors in the area were among the few people who had gained access to the Bin Laden compound in the past, administering polio drops to some of the children.

Afridi had posters for the vaccination programme put up around Abbottabad, featuring a vaccine made by Amson, a medicine manufacturer based on the outskirts of Islamabad.

In March health workers administered the vaccine in a poor neighbourhood on the edge of Abbottabad called Nawa Sher. The hepatitis B vaccine is usually given in three doses, the second a month after the first. But in April, instead of administering the second dose in Nawa Sher, the doctor returned to Abbottabad and moved the nurses on to Bilal Town, the suburb where Bin Laden lived.

It is not known exactly how the doctor hoped to get DNA from the vaccinations, although nurses could have been trained to withdraw some blood in the needle after administrating the drug.

"The whole thing was totally irregular," said one Pakistani official. "Bilal Town is a well-to-do area. Why would you choose that place to give free vaccines? And what is the official surgeon of Khyber doing working in Abbottabad?"

A nurse known as Bakhto, whose full name is Mukhtar Bibi, managed to gain entry to the Bin Laden compound to administer the vaccines. According to several sources, the doctor, who waited outside, told her to take in a handbag that was fitted with an electronic device. It is not clear what the device was, or whether she left it behind. It is also not known whether the CIA managed to obtain any Bin Laden DNA, although one source suggested the operation did not succeed.

Mukhtar Bibi, who was unaware of the real purpose of the vaccination campaign, would not comment on the programme.

Pakistani intelligence became aware of the doctor's activities during the investigation into the US raid in which Bin Laden was killed on the top floor of the Abbottabad house. Islamabad refused to comment officially on Afridi's arrest, but one senior official said: "Wouldn't any country detain people for working for a foreign spy service?"

The doctor is one of several people suspected of helping the CIA to have been arrested by the ISI, but he is thought to be the only one still in custody.

Pakistan is furious over being kept in the dark about the raid, and the US is angry that the Pakistani investigation appears more focused on finding out how the CIA was able to track down the al-Qaida leader than on how Bin Laden was able to live in Abbottabad for five years.

Over the weekend, relations were pummelled further when the US announced that it would cut $800m (£500m) worth of military aid as punishment for Pakistan's perceived lack of co-operation in the anti-terror fight. William Daley, the White House chief of staff, went on US television on Sunday to say: "Obviously, there's still a lot of pain that the political system in Pakistan is feeling by virtue of the raid that we did to get Osama bin Laden, something the president felt strongly about and we have no regrets over."

The CIA refused to comment on the vaccination plot.

Source: Guardian (UK)

File Under WTF: Did the CIA Fake a Vaccination Campaign?


A number of years ago, I was in New Delhi, at the end of an exhausting 18 hours in which I had torn around the city to watch a National Immunization Day. On those days — like a national holiday, with flags and banners and kids let out from school — tens of millions of children line up to stick out their tongues and receive the sugary drops that contain the vaccine that should protect them against polio.

The Indian government, along with the Centers for Disease Control, the World Health Organization and the volunteer ground troops of Rotary International, has been organizing these days now for most of two decades, always coming closer to the goal of eradicating polio, never quite getting there. On this day, which occurred close to the end of weeks I had spent embedded with a WHO “STOP Polio” team, 135 million children were expected to queue in cities and suburbs and rich neighborhoods and slums. I spent the day with the team I had been observing, racing in a battered turquoise Tata from neighborhood to neighborhood, trying to understand where the campaign’s message was working and where its earnest persuasions had failed. (You can read my account of the day here.)

There was one neighborhood, about 15 miles outside the center of New Delhi, where things were not going well. It was a Muslim area, and the local masjids supported the campaign — all the imams had preached in favor of it — but the appeals had not penetrated. Only a few children, about 25 in a slum that held thousands, had wandered up to receive the drops and the swipe of gentian violet across a fingernail that would signal to canvassers that a child had been immunized.

A young mother selling fish in a muddy side street shrugged and dismissed the importance of her four children receiving the vaccine. In the next few days, she said, the government would send “mop up” vaccinators into the alleys to find the children who had missed the big campaign. Maybe they would find her children; maybe she would get paying work that day, and then she would be away from home, and the children too. The government’s priorities were not hers.

Late that night, over whiskey-sodas served without ice because of the water quality, a longtime local health worker explained what he thought was going on. Hypothetically, protecting against polio requires four rounds of drops. But in tropical temperatures, with inadequate sanitation and endemic diarrheal diseases, it can take many more rounds of immunization to ensure a child is immune. That unplanned-for reality had combined with the longstanding distrust between Hindus and Muslims to produce a situation that no one had foreseen.

“We come back to their neighborhoods, month after month, telling them that these drops will protect their children from being paralyzed,” he said. “We come 10, 11, 12 times and the kids become paralyzed anyway. They start to think we’re doing this for some other reason, and they suspect us, and they don’t want to bring the kids out any more.”

And that is why the CIA’s decision to use a fake vaccination program in the hunt for Osama Bin Laden, if that story is true, is such an appallingly, idiotically bad idea.

As reported by the Guardian and subsequently by the New York Times, intelligence operatives funded a sham vaccination program in hopes of obtaining a sample of DNA to prove that bin Laden, then rumored to be in the area, was actually living in the compound where he was subsequently found and killed. From the Guardian:

DNA from any of the Bin Laden children in the compound could be compared with a sample from his sister, who died in Boston in 2010, to provide evidence that the family was present.

So agents approached [Shakil] Afridi, the health official in charge of Khyber, part of the tribal area that runs along the Afghan border.

The doctor went to Abbottabad in March, saying he had procured funds to give free vaccinations for hepatitis B. Bypassing the management of the Abbottabad health services, he paid generous sums to low-ranking local government health workers, who took part in the operation without knowing about the connection to Bin Laden. Health visitors in the area were among the few people who had gained access to the Bin Laden compound in the past, administering polio drops to some of the children…

In March health workers administered the vaccine in a poor neighbourhood on the edge of Abbottabad called Nawa Sher. The hepatitis B vaccine is usually given in three doses, the second a month after the first. But in April, instead of administering the second dose in Nawa Sher, the doctor returned to Abbottabad and moved the nurses on to Bilal Town, the suburb where Bin Laden lived.

There is no evidence the “vaccinations” produced DNA that helped identify bin Laden. The physician named in the article has been arrested by the Pakistani security forces. The CIA has understandably refused any comment. But the allegation that a vaccine program was not what it seemed — that it was not only suspect, but justifiably suspect — has been very widely reported.

This is awful. It plays, so precisely that it might have been scripted, into the most paranoid conspiracy theories about vaccines: that they are pointless, poisonous, covert shields for nefarious government agendas meant to do children harm.

That is not speculation. The polio campaign has already seen this happen, based on just those kind of suspicions — not in a single poor slum in New Delhi, but across much of sub-Saharan Africa.

In the fall of 2003, a group of imams in the northern Nigerian state of Kano — the area that happened to have the highest rate of ongoing polio transmission — began preaching against polio vaccination, contending that what purported to be a protective act was actually a covert campaign by Western powers to sterilize and kill Muslim children. The president of Nigeria’s Supreme Council for Sharia Law said to the BBC: “There were strong reasons to believe that the polio immunisation vaccine was contaminated with anti-fertility drugs, contaminated with certain virus that cause HIV/AIDS, contaminated with Simian virus that are likely to cause cancers.”

The rumors caught like wildfire, and they were spread further by political operatives who saw an opportunity to disrupt a recent post-election power-sharing agreement between the Muslim north and the Christian south. Three majority Muslim states — Kano, Kaduna and Zamfara — suspended polio vaccination entirely. Vaccination acceptance in the rest of the country fell off so sharply that the national government was forced to act. It ordered tests of the vaccine by Nigeria’s health ministry and empaneled a special commission to visit the Indonesian labs where the vaccine administered in Nigeria was made. The WHO convened emergency meetings.

And polio began to spread. At the end of 2003, when the boycott began, there had been only 784 known polio cases in the entire world. By the end of 2004, there had been 793 new cases just in Nigeria. Polio leaking across Nigeria’s borders reinfected Benin, Botswana, Burkina Faso, Cameroon, Chad, the Central African Republic, Cote d’Ivoire, Ethiopia, Ghana, Guinea, Mali, Sudan and Togo. Nigerian strains appeared in Yemen, site of the largest port on the Red Sea, and in Saudi Arabia, imperiling the millions of pilgrims coming to the country on hajj. (Here’s a 2004 round-up of the consequences from the South African publication Science in Africa, and one that I wrote in 2005.)

The last holdouts in Kano did not fully accept polio vaccination until the end of 2004. By then, so many children had gone unprotected that when Nigeria experienced the random bad luck of a vaccine-virus reversion to wild type in 2006, it ripped through the country in weeks — and further fueled lingering suspicions that had never really gone away.

The accusations that polio vaccination was a Potemkin cover for anti-Islamic activities almost ruined the international eradication of polio when they were false. Now, on the basis of the CIA’s alleged appalling ruse in Pakistan, they may be made again. And they will be much more believable, because this time they might be be true.

Notable reactions, among many: Longtime global-health reporter Tom Paulson says this will “undermine global health“; Seth Mnookin, author of The Panic Virus, calls it a “horrible move with potentially dangerous consequences“; infectious-disease physician Kent Sepkowitz says it’s a “paranoid’s dreamy nightmare“; and blogger Brett Keller bluntly calls it “despicable.” (Update: The Guardian’s Sarah Boseley adds: “a black day for medical ethics and a one-off crazy scheme.”)

I agree with them all.

Source: Wired

Addendum: In this report from December 2012 the Taliban killed five women administering polio vaccine in Pakistan. They think the vaccine makes children sterile. This attack is probably the end of any prospect of eradicating polio in our generation. Volunteers will fear to participate and health workers may start traveling with armed security.

In later news, the United Nations suspended the vaccination drive after the number of dead workers rose to eight. No one has claimed responsibility, but the Taliban is suspected.



Gunmen kill 5 women working on polio campaign opposed by Taliban in Pakistan

KARACHI, Pakistan — Gunmen shot dead five women working on U.N.-backed polio vaccination efforts in two different Pakistani cities on Tuesday, officials said, a major setback for a campaign that international health officials consider vital to contain the crippling disease but which Taliban insurgents say is a cover for espionage.

Pakistan is one of only three countries where polio is endemic. Militants however accuse health workers of acting as spies for the U.S. and claim the vaccine makes children sterile. Taliban commanders in the troubled northwest tribal region have also said vaccinations can’t go forward until the U.S. stops drone strikes in the country.

Insurgent opposition to the campaign grew last year after it was revealed that a Pakistani doctor ran a fake vaccination program to help the CIA track down al-Qaida chief Osama bin Laden, who was hiding in the town of Abbottabad in the country’s northwest.

The Taliban have targeted previous anti-polio campaigns, but this has been a particularly deadly week. The government is in the middle of a three-day vaccination drive targeting high risk areas of the country as part of an effort to immunize millions of children under the age of five.

“Such attacks deprive Pakistan’s most vulnerable populations — especially children — of basic life-saving health interventions,” said a statement jointly released by the government and the U.N. “We call on the leaders of the affected communities and everyone concerned to do their utmost to protect health workers and create a secure environment so that we can meet the health needs of the children of Pakistan.”

The women who were killed Tuesday — three of whom were teenagers — were all shot in the head at close range. Four of them were gunned down in the southern port city of Karachi, and the fifth in a village outside the northwest city of Peshawar. Two men who were working alongside the women were also critically wounded in Karachi.

The attacks in Karachi were well-coordinated and occurred within 15 minutes in three different areas of the city that are far apart, said police spokesman Imran Shoukat. In each case, the gunmen used 9 millimeter pistols. Two of the women were teenagers, aged 18 and 19, and the other two were in their 40s, he said.

Two of the women were killed while they were in a house giving children polio drops, said Shoukat. The other two were traveling between houses when they were attacked, he said.

On Monday another person working on the anti-polio campaign, a male volunteer, was gunned down in Karachi. Taliban militants also killed three soldiers in an ambush of an army convoy escorting a vaccination team in the northwest.

Officials in Karachi responded to the attacks by suspending the vaccination campaign in the city, said Sagheer Ahmed, the health minister for surrounding Sindh province. The campaign started on Monday and was supposed to run through Wednesday, he said.

Immunization was suspended in Karachi in July as well after a local volunteer was shot to death and two U.N. staff were wounded.

There were conflicting reports about whether the campaign was also temporarily suspended in Khyber Pakhtunkhwa province, where the fifth woman was killed Tuesday.

The statement released by the government and the U.N. said the drive was halted in both Sindh and Khyber Pakhtunkhwa.

But Janbaz Afridi, a senior health official in Khyber Pakhtunkhwa, said he had not received any suspension orders and planned to continue the campaign on Wednesday.

“These incidents are depressing and may cause difficulties in the anti-polio drive, but people should not lose heart,” said Afridi. “The government is very serious, and we are determined to eliminate polio despite all odds and difficult conditions.”

The shootings in Karachi all took place in areas mainly populated by ethnic Pashtuns, said Ahmed, the health minister. The Taliban are a Pashtun-dominated movement, and many militants are reported to be hiding in these communities in the city.

Rukhsana Bibi, whose 18-year-old daughter Madiha was killed in Karachi, seemed to blame the organizers of the vaccination campaign for her death.

“Why are you doing this by coming here?” said Bibi, standing next to her daughter’s body at the hospital. “This is a prohibited area. Taliban are here.”

Madiha was the only source of income for the family, which includes seven other children, said Bibi, whose husband is too sick to work.

The woman who was killed in the northwest was also a teenager and was shot by gunmen on a motorcycle as she was working with her sister in the village of Shinkai Hindkian, said Afridi, the local health official. She was rushed to the hospital after the attack but eventually died from her injuries, said Afridi.

Another official in Khyber Pakhtunkhwa, information minister Mian Iftikhar Hussain, said the woman was shot by her cousin because of a family dispute. He said she was working on the anti-polio campaign at the time, but he claimed the two things were unrelated.

Polio usually infects children living in unsanitary conditions, attacks the nerves and can kill or paralyze. Most of the new cases in Pakistan are in the northwest, where the presence of militants makes it difficult to reach children. A total of 56 polio cases were reported in Pakistan during 2012, said Ahmed, the Sindh health minister.

Despite the obstacles, the government has teamed up with U.N. agencies to give oral polio drops to 34 million children under the age of five. Clerics and tribal elders have been recruited to support polio vaccinations in an attempt to open up areas previously inaccessible to health workers

Also Tuesday, two men on a motorcycle hurled hand grenades at the main gate of an army recruiting center in the northwestern town of Risalpur, wounding 10 people, including civilians and security personnel, said senior police official Ghulam Mohammed.

Gunmen on a motorcycle also shot a member of an anti-Taliban militia in the northwest Swat Valley, said senior police official Gul Afzal Khan.

Pakistani Taliban spokesman Ahsanullah Ahsan claimed responsibility for both attacks by telephone to The Associated Press.

Source: Washington Post

Addendum: In May 2014 the New York Times reports that polio is resurgent. There is no mention of the fake vaccinations in Abbottabad.



Polio’s Return After Near Eradication Prompts a Global Health Warning

Alarmed by the spread of polio to several fragile countries, the World Health Organization declared a global health emergency on Monday for only the second time since regulations permitting it to do so were adopted in 2007.

Just two years ago — after a 25-year campaign that vaccinated billions of children — the paralyzing virus was near eradication; now health officials say that goal could evaporate if swift action is not taken.

Pakistan, Syria and Cameroon have recently allowed the virus to spread — to Afghanistan, Iraq and Equatorial Guinea, respectively — and should take extraordinary measures to stop it, the health organization said.

“Things are going in the wrong direction and have to get back on track before something terrible happens,” said Gregory Hartl, a W.H.O. spokesman. “So we’re saying to the Pakistanis, the Syrians and the Cameroonians, ‘You’ve really got to get your acts together.' ”

The declaration, which effectively imposes travel restrictions on the three countries, represented a newly aggressive stance by the health organization. In the past, it has often bent to pressure from member states demanding no consequences even as epidemics raged inside their borders and sometimes slipped over them.

“This is a fundamental shift in the program,” said Dr. Bruce Aylward, the organization’s chief of polio eradication. “This is the countries of the world signaling that they will no longer tolerate the spread of the virus from the countries that aren’t finished.”

The emergency was declared though the total number of known cases this year is still relatively small: 68 as of April 30, compared with 24 by that date last year.

What most alarmed experts, Mr. Hartl said, was that the virus was on the move during what is normally the low transmission season from January to April.

“What we don’t want is cases moving into places like the Central African Republic, South Sudan or the Ukraine,” said Rebecca M. Martin, director of global immunization for the Centers for Disease Control and Prevention, which has provided money and expertise to the eradication campaign since it began in 1988.

Fighting the virus normally includes several rounds of vaccination of all young children in a target country. But, in an unusual step, the agency also said that all residents of Pakistan, Syria and Cameroon, of all ages, should be vaccinated before traveling abroad, and that this restriction should be retained until one year after the last “exported case.”

It also said another seven countries should “encourage” all their would-be travelers to get vaccinated. Those are Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Nigeria and Somalia.

Israel has had no confirmed human cases of the disease, but a Pakistan strain of the virus has been detected in sewage in Tel Aviv and elsewhere.

While the W.H.O. has no enforcement power, the regulations are part of a 2007 global health treaty saying all parties “should ensure” that steps it recommends are taken. That applies to Pakistan, Syria and Cameroon. The other seven only need to “encourage” those steps.

But countries could use the document to refuse to admit migrants, visitors or even business travelers who lack vaccination cards.

Polio, short for poliomyelitis, is a highly contagious virus spread in feces; although only one case in 200 causes symptoms, the hardest-hit victims can be paralyzed or killed. With so many silent carriers, even one confirmed case is considered a serious outbreak. There is no cure.

Unlike influenza or other winter viruses, polio thrives in hot weather. Cases start rising in the summer and often explode when the monsoon rains break the summer heat, flooding sewage-choked gutters and bathing the feet of romping children with virus, which they pick up by touching their feet or a ball and then putting a finger in a mouth.

Though the disease primarily strikes children, evidence has mounted that it also crosses borders in adult carriers, such as traders, smugglers and migrant workers.

With 54 of this year’s 68 new infections, Pakistan is by far the riskiest country, Dr. Aylward said. Polio has never been eliminated there, Taliban factions have forbidden vaccinations in North Waziristan for years, and those elsewhere have murdered vaccine teams.

Syria has had only one confirmed case of polio this year, but it had 13 cases last October, the first in the country since 1999.

Before the uprising began in 2011, Syria had a 90 percent vaccination rate, but it fell rapidly in war-torn areas. About 300,000 children are in areas blocked off by the government or too dangerous to reach, according to the United Nations Children’s Fund.

The Syrian cases from last year were of the Pakistan strain, which was found in Egypt last year, then moved into Israel, first in a largely Bedouin desert town, then elsewhere. How it reached Syria is unclear, but in April it was found in a Syrian refugee camp in Iraq, despite extensive vaccination campaigns in camps in Lebanon, Jordan, Turkey and elsewhere.

“Fortunately, it’s pretty easy to do in refugee camps,” Mr. Hartl said.

With Syrians fleeing massacres and bombings, it seems absurd to make them stop and produce vaccination cards, critics said.

Cameroon’s outbreak is of a strain from Nigeria, which previously had more cases than any country in the world but which has had only two so far this year. As in Pakistan, Islamic terrorist groups in Nigeria have killed vaccinators. Nonetheless, multiple vaccination rounds have reduced the problem.

Cameroon, Equatorial Guinea and other African countries are all vulnerable because their routine immunization rates are so low; in Equatorial Guinea, only 26 percent of all children are protected, Dr. Martin said

It is unclear whether the new travel restrictions will hurt the economies of the affected countries. Pakistan already has vaccination booths where its highways enter Afghanistan, China and Iran.

Pakistan’s health minister, Saira Afzal Tarar, said her office had recommended vaccinating travelers at the country’s five international airports before they board. (The W.H.O. calls for vaccination at least four weeks before traveling, except in emergencies.)

She expressed her disappointment at the restrictions, saying, “We have been doing whatever we can, but due to the law and order situation in our country, especially in the two tribal regions, we are facing extraordinary challenges.”

Until 2012, the world was making enormous progress toward eliminating polio. India, which once had millions of cases, had its last three years ago. Monday’s emergency was declared both to alert donors and to pressure the affected countries to organize vaccination drives, Mr. Hartl said.

That means recruiting and training hundreds of thousands of vaccinators, and sending them into the field with millions of doses of vaccine, which must be kept cold, usually by packing them on ice in a foam plastic box each vaccinator carries on a shoulder strap.

It is a huge logistical undertaking. Vaccinators go door to door in villages and cities, approach passengers at railway stations and on buses, and walk up to cars at toll plazas and in traffic circles. The ideal is to vaccinate every child in the country several times, with a month or so between each round.

It also entails many conflicts. Even when there is no local opposition, there are struggles over issues including who gets the vaccinator jobs, which usually pay $2 to $5 a day, and who controls the gas money for minibuses taking teams to villages.

Source: New York Times